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Coconut Surveillance
Improving Surveillance and Response for Malaria Elimination
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Malaria Is a Global Killer
1. Source: World Health Organization, Global Health Observatory Data Repository
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But Malaria Is Preventable, CurableMalaria-Free, Eliminating, and Controlling Countries, 20121
1. Source: UCSF Global Health Group, Malaria Elimination Group
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The Case of Zanzibar
East Africa
2 large islands (Unguja, Pemba)
A semi-autonomous part of the United Republic of Tanzania
Malaria Control Phases in ZanzibarHealth facility trends: Malaria confirmed cases and positivity rate, 1999–2014
0.0
5.0
10.0
15.0
20.0
25.0
30.0
35.0
40.0
45.0
0
500
1000
1500
2000
2500
Positive slides Positivity rate
Po
sit
ivit
y r
ate
(%
)
# o
f p
os
itiv
es
Gain after ACT introduction and
before scale-up of mosquito control
Gain before ACT introduction
Zanzibar Is Nearing Elimination
1. Source: Zanzibar Malaria Elimination Program
– for the Third Time
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But There Are Challenges
Decreasing effectiveness of mosquito control
Population resistance to behavior change
Case importation from mainland Tanzania
An effective surveillance and rapid response system is essential
Using dwindling resources more effectively
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Monitoring the Process and Targeting Resources
1,328 new cases,including asymptomatic cases, detected and treated
Rapid diagnostic tests administered and data collected from more than
22,350 household members
Used to respond to more
than 5,132 new malaria case reports
All 20 district malaria surveillance officers use Coconut Surveillance
All 154 government primary care units use the case alert system
78% of private clinics use the case alert system
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Social Impact
584,000 people died of malaria in 2013
500,000 died in Africa
400,000 were children under 5 years old
Nearly half the world’s population are at risk1
It costs Africa $12 billion each year2
1. World Health Organization, World Malaria Report 2014. 2. Gallup JL, Sachs JD, 2001. The economic burden of malaria. AJTMH 64 (Suppl 1–2): 85–962.3. World Health Organization, Malaria Fact sheet No94, April 2015.
Stronger malaria surveillance systems are urgently needed3
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Scaling Up
Unique
Free and open source
$350 / year for cloud hosting
$510 / year for each mobile user
$10,200 / year total for 20 users
Easy to adopt
Adaptable and Scalable
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2014 – World Health Organization establishes vision for “A world free of malaria”
Scaling Up
35 countries are pursuing malaria elimination
2005 – U.S. President’s Malaria Initiative launches $1.265 billion expansion to reduce malaria in Africa
2013 – U.S. $2.7 billion funding for malaria control and elimination
2014 – Bill & Melinda Gates Foundation sets goal of eradicating malaria by mid-21st century and boosts anti-malaria funding by 30 percent.
Questions – [email protected]
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“We must remain committed to the eradication of malaria. Small steps won’t get the job done.” – Bill Gates